IT Band syndrome

Hi all

I am 46 and swim regularly (3 days a week). About a couple of months ago I started noticing pain on the outside of my knee on my dolphin kicks. Eventually I started feeling the pain when pushing from the walls, going up on stairs, and also when kicking breastroke. At that point I went to a physio as I was pretty worried. He said that it was my IT band and recommended strengthening exercises on my glutes, foam roiling and IT band stretches.  Its been 2 months since that, I've been doing all the stretches, foam rolling, took a full week off from the pool and eased my way back into workouts after the break, doing more pulling, no dolphin kicks until I felt like it was time to give it a go again. I felt ok when pushing of the walls yesterday but the pain is still there when kicking breastroke and also when I go full range of motion when snapping my knee for the dolphin kicks.

Has anyone gone through some similar? I live in Canada and to see a knee specialist may take some time. I am looking for some advice as I feel this is not progressing well. I have been seeing my physio regularly and he has noticed that I gotten better outside of the pool (stairs are ok now) but somehow I haven't been able to do dolphin or breastroke kicking and being a breastroker/IMer it sucks that I can't really work on those strokes. My goal was to go to Nationals in April, but given the last couple is not looking promising. 

Thanks

Carlos

  • Carlos,

    I am not a PT - only many years of coaching, my own swimming, and a knee replacement 16 months ago.  So my suggestions are simply things to see if they will help you. 

    If I learned nothing else from my knee replacement, I now understand how complex the muscles, ligaments, and tendons that support the knee really are.  Although IT band problems can take a long time to resolve, you might also consider the possibility that you have some muscle imbalances that result in uneven stress.

    When I was coaching, if swimmers complained about knee pain, my go-to advice were three things:

    1. Add stretches for the hamstrings - usually forward folds.  While all kicking requires good hamstring strength, breaststroke and dolphin kick work them the most.  If you are doing alot of hamstring curls in the weight room, this could be aggravating the condition.  Foam rolling your hamstrings may help to relax the muscle.  Also, alot of knee extensions could be causing the imbalance.
    2. Self-massage all areas of the quadriceps with a foam roller or the heel of your hand - outside of the quad (hitting the IT band), center and inside thigh.  I find massage with my hand more effective than foam rolling.
    3. Straddle stretches - these stretches work on imbalances from the muscles on the inside of your thigh being too tight.  If you do any abductor and adductor sets to strengthen these muscles, there might be an imbalance here.   Start out easy with these stretches - they take time to to see results.

    If any of these yield results - even temporarily - you might be onto something.  If you do alot of bicycling, the quads get strong and the hamstrings never get stretched out.

    Although you are "young", if the pain persists, you should not dismiss the possibility you have a slight tear in one of the ligaments and/or meniscus.  Diagnosing these requires an MRI.

    These suggestions are simply layman ideas.  Hope they help and you get to Nationals!

    Paul

  • Hey Paul,

    I appreciate your detailed response. One thing I have neglected is foam rolling my hamstrings so I will give that a go and will also incorporate your recommended stretches. 

    Thanks again

    Carlos

  • Here is a great article on IT Band Syndrome: https://www.usms.org/fitness-and-training/articles-and-videos/articles/self-massage-for-it-band-syndrome?Oldid=3101 

    Hopefully this helps. I know a few swimmers who have gone through it and remember a few noting things started to improve after they strengthen and stretched but also rested a bit after it caused pain because it took awhile for the swelling to go down.